基于视频的决策辅助工具改善睡眠手术决策:一项随机对照试验
Arushi Gulati1, Hasan Abdulbaki1, Jacquelyn K Callander1
1Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, U.S.A.
The Laryngoscope
|November 15, 2023
概括
咨询前的视频可以改善阻塞性睡眠呼吸暂停 (OSA) 患者的决策,考虑正气道压力 (PAP) 替代方案. 虽然决策冲突在两组中同样有所改善,但视频提高了干预患者的决策阶段.
科学领域:
- 睡眠医学 睡眠医学
- 手术决策 - 手术决策
背景情况:
- 患有阻塞性睡眠呼吸暂停 (OSA) 的患者在选择正气道压力 (PAP) 和手术替代方案之间时,经常经历高决策冲突 (DC).
- 需要有效的决策支持工具来帮助患者在这些复杂的治疗选择中进行导航.
研究的目的:
- 评估前咨询视频决策辅助器对患者DC和考虑PAP替代品的OSA患者的决策准备能力的影响.
- 评估视频决策辅助器如何影响患者的决策阶段和整体咨询经验.
主要方法:
- 考虑PAP替代品的成年OSA患者被随机分配到接受咨询前视频 (干预) 或没有视频 (控制).
- 决策冲突,决策准备和患者参与被评估,使用问卷和咨询录音.
- 高冲突患者被确定为那些考虑三种或更多治疗方案的患者.
主要成果:
- 这两组在DC分数中均显示出显著的访问后改善,干预组和对照组之间没有显著差异.
- 干预组在决策阶段取得了显著的进步,更多的患者在访问后报告"接近选择一种选择".
- 对于高冲突患者来说,访问前的视频使用与更少的口语和更短的咨询时间有关.
结论:
- 考虑用于OSA的PAP替代品的患者表现出高水平的决策冲突.
- 咨询前的视频决策辅助工具显示了提高睡眠手术候选人的治疗决策过程的潜力.
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